Atrial Septal Defects That Present in Infancy

Mahoney, Larry T.

doi:10.1001/archpedi.1986.02140250041032

Cited by 22 publications

(28 citation statements)

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“…Therefore, the patients are often adolescents or adults by the time the diagnosis is made [1,12]. There are some investigations that deal with ASDs in younger children who have symptoms from the defect, thus indicating that ASDs can in fact lead to heart failure in infancy [3,8,9,11,14,15,18].…”

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“…Large secundum ASDs need surgical closure, although the size of ASD is not well documented nor is the need for surgical closure. For large secundum ASD elective surgery is generally recommended at 4-6 years of age [7,12,13,17]. Spontaneous closure does not seem to be affected by symptoms since spontaneous closure has been reported in patients with heart failure in infancy [2,12,13,17].…”

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confidence: 99%

“…For large secundum ASD elective surgery is generally recommended at 4-6 years of age [7,12,13,17]. Spontaneous closure does not seem to be affected by symptoms since spontaneous closure has been reported in patients with heart failure in infancy [2,12,13,17]. Early publications dealing with spontaneous closure of ASD report the incidence of spontaneous closure to be 14-55% [7,12,13,17].…”

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confidence: 99%

“…Spontaneous closure does not seem to be affected by symptoms since spontaneous closure has been reported in patients with heart failure in infancy [2,12,13,17]. Early publications dealing with spontaneous closure of ASD report the incidence of spontaneous closure to be 14-55% [7,12,13,17]. Recently, the spontaneous closure rate has been given as between 66% and 92% [16].…”

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Spontaneous Closure of Atrial Septal Defects

Helgason

1999

Pediatr Cardiol

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Atrial septal defects (ASDs) are found more frequently in the pediatric population than in adults, and improved diagnostic techniques with echocardiography (2DE) and Doppler facilitate diagnosis so that repair is possible at an optimal time. The purpose of our investigation was to study the size of ASDs at diagnosis, how size changes during follow-up, and to explore the relationship between size at diagnosis and need for surgery. We reviewed the medical records of all patients in Iceland with the diagnosis of ASD born between 1984 and 1993. ASD was confirmed by 2DE in all patients and defects smaller than 4 mm were excluded. ASD size was measured by 2DE from subxyphoid long and short axis views. There were 91 patients-29 males and 62 females. Four patients died from causes other than the heart defect and had not been operated upon. Seven patients with ASD primum and sinus venosus defects were excluded from analysis. There were 29 patients with a 4 mm defect, 17 patients with 5 or 6 mm defects, 8 patients with 7 or 8 mm defects, and 26 patients had defects >8 mm. In the 4 mm group, in 26 patients (89%) the ASD closed spontaneously or decreased in size, and 1 patient had been operated upon. In the 5 or 6 mm group, 15 of 19 ASDs (79%) had closed spontaneously, and 2 patients (9.5%) had been operated upon. In the 7 or 8 mm group, 1 of 6 ASDs (16.6%) had closed spontaneously and 3 had been closed surgically. In the >8 mm group, 1 of 24 ASDs had closed spontaneously and 20 (91%) had been closed surgically. We conclude that defects smaller than 6 mm in diameter are very likely to close spontaneously although follow-up is necessary. Defects larger than 8 mm have a high probability requiring operative closure.

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Spontaneous Closure of Atrial Septal Defects

Helgason

1999

Pediatr Cardiol

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“…Although compatible with an uneventful evolution up to the sixth decade of life, it is very well established that patients who have ASD-II have higher morbidity rates and shorter life expectancy compared with the normal population. For this reason, its closure is recommended in the preschool age, even if asymptomatic, or soon after it is diagnosed [1][2][3].…”

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Eventos catastróficos associados ao tratamento da comunicação interatrial tipo ostium secundum: razões para não se subestimar este tipo de cardiopatia congênita

Évora¹,

Ribeiro²,

Vicente³

et al. 2004

Rev Bras Cir Cardiovasc

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Objective: The present article was motivated by the frustrating experiences with four patients who underwent surgical treatment of ostium secundum atrial septal defect (ASD-II) and who died in extremely dramatic circumstances.Method: This is a retrospective study based on clinical data. The bibliographical research included: paradoxical thromboembolism (cerebral, pulmonary or mesenteric), central nervous system vascular malformations and anomalous vena cava connections. This research was based on possible events, unexpected and catastrophic, that could have directly caused the patients' deaths.Results: All patients were female. The operations were performed under cardiopulmonary bypasses with less than 20 minutes of aortic cross-clamping. The causes of death were: non-occlusive intestinal ischemia, rupture of a cerebral aneurysm of the anterior communicating artery, cor pulmonale associated with pulmonary arterial hypertension and thromboembolism and probable cerebral thromboembolism in a child that needed to be reoperated to correct anomalous inferior vena cava drainage into the left atrium.Conclusion: Even being technically easy to treat, death due to atrial septal defects in extremely dramatic circumstances is possible, so "Do not underestimate atrial septal defects in congenital heart surgery". Descriptors:Heart septal defects, atrial, surgery, complications. Heart defects, congenital, surgery, complications. Extracorporeal circulation.Eventos catastróficos associados ao tratamento da comunicação interatrial tipo ostium secundum: razões para não se subestimar este tipo de cardiopatia congênita Catastrophic events associated to the surgical treatment of ostium secundum atrial septal defects. Reasons for not underestimating this type of congenital cardiopathy 392 EVORA, PRB ET AL -Catastrophic events associated to the surgical treatment of ostium secundum atrial septal defects. Reasons for not underestimating this type of congenital cardiopathy Braz

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